The use of folic acid, iron salts and other vitamins by pregnant women in the 2015 Pelotas birth cohort: is there socioeconomic inequality?

Abstract

Background Many low- and middle-income countries recommend micronutrient supplements for pregnant women to improve their nutritional status, prevent possible deficiencies and avoid fetal healgth consequences. This study evaluated the influence of socioeconomic status on the use of folic acid, iron salts and other vitamins and minerals among pregnant women in the 2015 Pelotas Birth Cohort. Methods This population-based birth cohort study was carried out with 4270 women. Participants were interviewed during pregnancy and at the maternity hospital about the antenatal period; including the use of iron salts, vitamins and other minerals. Descriptive analyses were performed to characterize the sample. The analyses were adjusted according to socioeconomic variables (maternal education, ethnicity, household income). Results The overall prevalence of the use of folic acid, iron salts or other vitamins and minerals was 91.0% (95% CI: 90.1–91.8). Specifically, 70.9% (95% CI: 69.5–72.3) used folic acid, 72.9% (95% CI: 71.5–74.3) used iron compounds, and 31.8% (95% CI: 30.3–33.2) used other vitamins or minerals. In the adjusted analysis, the use of iron salts was associated with nonwhite mothers, with ≤4 years of education and whose family income was less than or equal to the monthly minimum wage. The use of folic acid and other vitamins and minerals was associated with white mothers who were more highly educated and had a higher family income. Conclusion Although folic acid and other vitamins and minerals were more frequently used in white, richer and more educated mothers, which indicates inequality, iron supplements were more frequently used in the poorer, less educated nonwhite mothers, suggesting the opposite association for this supplement.

Routine haematinics and multivitamins: Adherence and its association with haemoglobin level among pregnant women in an urban lower‐middle‐income country, Ghana

“…Primiparous women were found to be more adherent than nulliparous and multiparous with the uptake of all the medications studied. That multiparous women used less has been reported by Miranda et al Although these authors did not directly measure the adherence, this use could be extended, albeit cautiously to adherence. The reason for the poor adherence among multiparous women is that after a number of deliveries, mothers can afford some degree of laxity towards the babies they are carrying.…”

“…Studies have indicated that regular intake of iron and folic acid improves the haemoglobin levels and iron stores of pregnant women . A recent report from Brazil suggests a socio‐economic inequality in the use of iron salts, folic acid and vitamins among mothers, where use of iron salts was associated with non‐whites, while use of folic acid and vitamins was linked to white and richer mothers . However, the adherence with routine haematinics among women in lower‐middle‐income countries (LMIC) has not been extensively reported.…”

Knowledge and awareness of folic acid usage in Saudi pregnant women in Riyadh city from 2019-2020

“…Lack of micronutrients and its deficiencies are commonly observed in women during pregnancy and supplements will be recommended to avoid the association of associated malabsorption diseases, high fertility rates, to avoid neural tube defects in the pregnancies, limited knowledge towards the intake of nutrition during pregnancy. [ 32 ] One of the possible factors might be socioeconomic differences of these study settings, ethnicity, and time phrase. Our study had performed when the pregnant women were at 20 weeks of gestation and Kassa et al .…”

Medication Use among Pregnant Women from the 2015 Pelotas (Brazil) Birth Cohort Study

“…The drugs were classified into pharmacological groups by the Anatomical Therapeutic Chemical (ATC) classification system [10] at levels 1 (anatomical group), 2 (therapeutic group), and 5 (chemical substance). In this paper, we do not consider the use of iron salts, folic acid, vitamins, and other minerals, because such supplements are routinely recommended to pregnant women and have been analyzed separately in another study [11]. The independent variables were the following: age (≤19, 20-29, 30-47 years), skin color (white, black, and mixed/other), education (0-4, 5-8, 9-11, and 12 or more years of schooling), current income in minimum wages considering the amount of R$ 788.00 (USD 200.00) as one wage in 2015 (≤1, from 1.1 to 3, from 3.1 to 6, from 6.1 to 10, and >10), parity (1, 2, 3, and 4 or more children), number of prenatal visits (less than 6 visits and 6 or more), marital status (with/without a partner), smoking during pregnancy (yes/no), number of chronic and/or acute health problems (none, 1, 2, 3, and 4 or more), hospitalization during pregnancy (yes/no), and trimester of onset of prenatal care (first, second, or third).…”